Dr. Dresner discusses the symptoms of postpartum psychosis.
Well, psychosis means loss of touch with reality. So the inability to distinguish what’s real from what’s not real, and in many individuals, that means hallucinations, hearing things that other people don’t hear, or seeing things that other people don’t see, feeling or smelling things that are not in other people’s experiences, and it also includes thought disorganization; so the inability to process and communicate information clearly.
And in new mothers, again it really depends on what the background diagnosis is. If this is a woman who has suffered from schizophrenia, and she is having a postpartum, maybe she has been off her psychotropic medications during pregnancy because the physician felt that they were unsafe to use, she is at extremely high risk for postpartum psychosis which would be just an exacerbation of her underlying psychiatric illness.
And for her, that will look just like what her psychotic episodes have looked like before. She might hear voices, she might see things, she might become paranoid. What we see commonly in new onset psychosis in new mothers is a feeling of activation and agitation, inability to sleep, inability to relax, a kind of urgency about accomplishing tasks, maybe the kind of energy certainly you wouldn’t expect to see in a new mother who should be exhausted.
And when I ask a new mother if she can sleep when her baby is sleeping and she says, “Oh no, I have so much energy. I really feel like I need to clean the baseboards, or I have company coming for the christening or the baby naming, and I have to get my house ready, and I have to start baking,” and this might be three or four days postpartum, that’s not normal, and that would concern me.
And so those kinds of symptoms combined with evolving poor judgment, feelings of alienation, and maybe then beginning to have some paranoia, suspiciousness, and more thought disorganization, behavioral disorganization, that’s sort of what we would begin to see in a postpartum psychosis as related to a new manic episode in a new mother.
About Dr. Nehama Dresner, M.D.:
Dr. Nehama Dresner, M.D., is a licensed, Board-certified psychiatrist (in general psychiatry and psychosomatic medicine) with specialized training and nearly 20 years experience in Women's Mental Health and Medical Psychiatry. She is Associate Professor of Clinical Psychiatry and Obstetrics/Gynecology at Northwestern University Feinberg School of Medicine and is actively involved in medical education. A fellow in the Academy of Psychosomatic Medicine and the America Psychiatric Association, she speaks locally and nationally on issues related to psychological aspects of women's health and medical psychiatry. Dr. Dresner's clinical specialty is psychosomatic obstetrics, and gynecology, women's emotional development, and psychiatric treatment of the medically ill.